Abstract

Patients in tertiary care hospitals are more complex than in the past, but the implications of this are poorly understood as 'patient complexity' has been difficult to quantify. A 'Complexity Ruler' was validated and tested in a case-control model of all patients with major adverse events at a tertiary care pediatric hospital from 2005 to 2006. Above empirically derived cutoffs, 24-hour and lifetime cognitive complexity of the medical records were risk factors for major adverse events